Cagrilintide

Home › Research › Cagrilintide

View Cagrilintide in the AxYn range →

Snapshot

Chemistry verified against PubChem REST API (CID 171397054): MolecularFormula C194H312N54O59S2, MolecularWeight 4409. The two sulfur atoms in the formula are the single Cys2-Cys7 disulfide bridge.

Chemistry and make-up

Cagrilintide is a synthetic 37-amino-acid peptide engineered from the amylin/pramlintide scaffold for once-weekly dosing. Three features define it. First, a single intramolecular disulfide loop (Cys2-Cys7) near the N-terminus, which is required for receptor activity and is the reason the molecular formula carries two sulfurs. Second, N-terminal acylation with a long fatty diacid (reported as a C20 eicosanedioic diacid) attached through a gamma-glutamic acid spacer; this “lipidation” lets the peptide bind reversibly to serum albumin, which is what stretches the half-life out to roughly a week [A]. Third, stabilising residue substitutions (proline and charge changes) chosen to blunt the amyloid-fibril aggregation that plagues native human amylin, so the molecule stays soluble and injectable [A]. The C-terminus is amidated. Because the active form depends on the correct disulfide and the intact acyl chain, QC for this peptide is not just purity: it needs mass confirmation (expected vs observed ~4409) and evidence the diacid modification is present and the disulfide is correctly formed, not a linear or mis-bridged variant.

What it is studied for (evidence)

• Mechanism: cagrilintide is a dual amylin and calcitonin receptor agonist. It signals through the amylin receptor complexes (calcitonin receptor plus RAMP subunits) and the calcitonin receptor itself, acting in the area postrema and hypothalamus to reduce appetite and increase satiety [A]. This is a different pathway from GLP-1 receptor agonists such as semaglutide, which is exactly why the two are combined: amylin and GLP-1 hit appetite through complementary routes.
• Established (good evidence): cagrilintide is one of the better-evidenced compounds in this file because it has real Phase 2 and Phase 3 human data. In a Phase 2 dose-finding study, cagrilintide monotherapy at 4.5 mg produced about 10.8% body-weight reduction over 26 weeks, exceeding liraglutide 3.0 mg in the same trial [A]. The half-life is long (published estimates ~159 to 195 h, about 7 days), supporting once-weekly subcutaneous use [A].
• CagriSema (the headline programme): the fixed-dose combination of cagrilintide 2.4 mg + semaglutide 2.4 mg. In REDEFINE 1 (adults with overweight/obesity, 68 weeks) CagriSema gave ~22.7% mean weight loss, versus 11.8% for cagrilintide alone, 16.1% for semaglutide alone and 2.3% for placebo [A]. In REDEFINE 2 (type 2 diabetes with overweight/obesity) it gave ~15.7% versus 3.1% placebo at 68 weeks [A].
• Emerging / thin: long-term cardiovascular-outcome and durability data are still maturing, and monotherapy cagrilintide (without semaglutide) has a smaller published footprint than the combination.
• Marketing claims vs data: research-peptide vendors sell “cagri” as a standalone weight-loss agent and publish dosing charts and reconstitution protocols. The genuine clinical data are for the investigational compound (mostly as CagriSema), delivered under trial conditions. Standalone RUO “cagrilintide” is not an approved product and vendor dosing is not a validated human protocol. Treat all such guidance as marketing, not evidence.
• Human clinical status: investigational. Not approved anywhere as of mid-2026. Novo Nordisk filed a CagriSema NDA with the FDA in December 2025, with a decision expected late 2026 or into 2027. Cagrilintide as a single agent remains earlier-stage.

Handling, format and stability

Supplied lyophilised for research handling; reconstituted with bacteriostatic or sterile water in a research context (no dosing guidance here). As a lipidated, disulfide-containing peptide it is sensitive to oxidation (which can scramble the disulfide) and to aggregation if mishandled, so cold storage of the lyophilised powder and protection from light and repeated freeze-thaw are the usual precautions. Reconstituted material is less stable and cold-chain dependent. The commercial reference products are once-weekly subcutaneous formulations, which reflects the ~7-day albumin-binding half-life rather than any property of powdered research material.

Regulatory and trade status

• UK/EU RUO: research use only; not an approved medicine in its own right. The bigger issue is category, not this specific molecule: cagrilintide is a metabolic / obesity compound that sits immediately next to the GLP-1 class (semaglutide, tirzepatide, retatrutide). That class is under intense MHRA, FDA and EMA scrutiny, is a magnet for enforcement against unlicensed weight-loss sales, and any claim of weight-loss benefit pushes a listing straight into “medicinal product by presentation” territory. Keep any handling strictly RUO with no metabolic or weight-loss claims whatsoever.
• US: the parent combination (CagriSema) is under FDA review, not approved. Standalone cagrilintide is not an approved drug and is not a recognised compounding bulk substance.
• WADA (sport): not individually named on the Prohibited List as of the current cycle, but as a non-approved investigational peptide hormone it is best treated as prohibited under S0 (non-approved substances) in sport, and its metabolic/appetite actions draw the same scrutiny as other weight-management agents. Grade this as cautious interpretation, not a cited WADA entry [B/interpretation].
• Customs / import: anything in the GLP-1/obesity adjacency carries elevated customs and enforcement risk because of the booming grey market in weight-loss injectables. Higher-profile and higher-risk than a tissue-repair peptide.

Sources

• [A] “Development of Cagrilintide, a Long-Acting Amylin Analogue”, *J Med Chem* 2021 — https://pubs.acs.org/doi/10.1021/acs.jmedchem.1c00565
• [A] “Cagrilintide: A Long-Acting Amylin Analog for the Treatment of Obesity” (review), PubMed 36883831 — https://pubmed.ncbi.nlm.nih.gov/36883831/
• [A] REDEFINE 1 CagriSema Phase 3, *NEJM* 2025 (22.7% weight loss) — https://www.prnewswire.com/news-releases/cagrisema-2-4-mg–2-4-mg-demonstrated-22-7-mean-weight-reduction-in-adults-with-overweight-or-obesity-in-redefine-1–published-in-nejm-302487770.html
• [A/D] ADA 2025 REDEFINE 2 readout summary, HCPLive — https://www.hcplive.com/view/ada-2025-cagrisema-demonstrates-dual-benefit-in-obesity-and-type-2-diabetes
• [B/commercial] Novo Nordisk FDA filing announcement (Dec 2025) — https://www.biospace.com/press-releases/novo-nordisk-files-for-fda-approval-of-cagrisema-the-first-once-weekly-combination-of-glp-1-and-amylin-analogues-for-weight-management
• [B] PubChem CID 171397054 (formula C194H312N54O59S2, MW 4409) — https://pubchem.ncbi.nlm.nih.gov/compound/171397054
• [D] Vendor pages (PeptideInsight, peptidedosage.org, Halflife Labs) — commercial; publish dosing, which we do not use.

Plain summary

Cagrilintide is a once-weekly, fat-tail-modified amylin analogue that curbs appetite through a different receptor system than the GLP-1 drugs, which is why Novo Nordisk pairs it with semaglutide as CagriSema. It has genuine Phase 3 human data (around 22.7% weight loss in combination) but is still investigational and not approved anywhere yet. For AxYn the single most important flag is that it is GLP-1-adjacent: it carries the highest-scrutiny, weight-loss enforcement risk in the landscape, so treat it as competitor intelligence to understand, not an easy SKU to stock.

For laboratory and research use only (RUO). Not for human or veterinary use, not for consumption, and not a medicine. Information is a research summary, not medical advice, and contains no dosing guidance.

For laboratory research use only. Not for human or veterinary use, not for consumption, and not a medicine. This is a research summary, not medical advice, and contains no dosing guidance.